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Parkview Hospital Inc. in Fort Wayne, Ind., failed in an effort to dismiss claims
that its inpatient psychiatric hospital, Parkview Behavioral Health Hospital, violated
the Emergency Medical Treatment and Labor Act (EMTALA) by following the hospital’s
policy for after-hours emergency patients and directing the man, Tyquan Stewart, to
the nearby emergency department at Parkview Randallia Hospital. Instead of going to
Randallia, Stewart crashed his car into a building in an attempt to commit suicide.

Under EMTALA, any hospital that has an emergency department can’t turn away an individual
with an emergency condition before performing a proper screening examination and necessary
stabilization treatment. The U.S. District Court for the Northern District of Indiana
said Oct. 20 that the existence of an affiliated emergency department less than a
mile away from Parkview Behavioral Health may have triggered the law’s duty to screen
and stabilize Stewart instead of sending him out to find the emergency department
on his own.

“This is a very straighforward reading of the law,” David W. Frank, an attorney with
Christopher C. Myers & Associates in Fort Wayne, Ind., who represented Stewart, told
Bloomberg Law. “If you show up at the hospital property and request emergency care,
you’ve done your duty as a patient under EMTALA, and the hospital can’t then turn
around and say that’s not good enough.”

Suicidal Patient

Stewart drove to Parkview Behavioral Health in the early morning hours of Dec. 20,
2015, and asked to be admitted, claiming he was having suicidal thoughts. Under a
hospital policy at the time, the security guard on duty denied him access and told
him to go to Parkview Randallia for admission, because that facility had a 24-hour
emergency department.

Shortly after that, Stewart drove his car into an apartment building in an effort
to commit suicide. Police who arrived on the scene took him to Parkview’s main campus
for admission where he was detained for the next four days.

“This was someone who the hospital knew had a long history of mental illness,” Frank
said. “He had PTSD [post-traumatic stress disorder], he had literally almost been
shot to death earlier, he had been treated at the hospital before and here he was,
driving up to the door of the mental health hospital, notifying them that he was suicidal
and that he planned on using his car to commit suicide, and they told him to go away
and use his car to go to another hospital a mile away.”

Four months after the incident, Stewart brought a civil rights suit against a variety
of state and county officials for conditions in the Allen County Jail and the Indiana
State Prison, but he included a claim for “malpractice” against Parkview for denying
his request for admission to the behavioral health hospital. Later amended versions
of the complaint refined that claim to include EMTALA violations against the hospital
and state-law negligence claims against the security guard who directed him away.

Sometime after the incident, Parkview changed its policy on after-hours arrivals at
the behavioral health hospital to require the hospital to transport any individuals
to Randallia for admission to the emergency department.

Not Medical Malpractice

In addition to allowing the EMTALA claim to survive pretrial judgment, the court also
refused to dismiss the negligence claims Stewart asserted against the hospital’s security
guard.

The hospital had argued that a negligence claim against the hospital or its employees
for failure to treat was governed by the Indiana Medical Malpractice Act and thus
Stewart was required to bring his claims to the state Department of Insurance before
bringing a claim in federal court.

The court disagreed, saying Stewart was never admitted and thus never qualified as
a patient of the hospital under the medical malpractice statute.

“Negligence is a state-by-state thing, but this is something that is necessarily going
to be intertwined with EMTALA,” Frank said. “If you show up at the hospital and someone
turns you away without any screening or treatment, of course it can’t be a medical
malpractice claim. They’ve denied you the status of being a patient in the first place.”

Frank said the case reflected the treatment gap that mentally ill patients are facing.

“We have a growing awareness of the need to take mental health seriously and to listen
to the people who have that disability,” he said. “We have to listen to them and treat
them seriously and not as just a burden on society.”

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